Myopia Control Using Specialized Spectacle Lenses: Results in a Portuguese Cohort

INTRODUCTION: Myopia is increasing worldwide and is projected to affect nearly 5 billion people by 2050. High myopia is a major risk factor for vision-threatening complications and children with fast-progressing myopia require early intervention and monitoring. Several interventions have showed to effectively slow progression, and options based on peripheral defocus lenses showed promising results in clinical trials. Our study aimed to evaluate myopia progression in a Portuguese children cohort using different lens designs in a real-world setting, and to assess the role of age and parental myopia. We also described lifestyle habits that could influence progression. METHODS: This was a prospective, non-randomized interventional study. Children aged 5 to 17 years with a myopia diagnosis were prescribed specialized lenses commercially avail- able (Stellest®, MiyoSmart®, Optimee® or MiyoCare®) and followed at 6 months, 1 and 2 years. Cycloplegic refraction and axial length (AL) were measured at each visit. The primary outcome was myopia progression, expressed as the change in spherical equivalent refraction (SER) dur- ing follow-up. The secondary outcome was axial length elongation over time. Subgroup analyses compared outcomes by parental myopia, age at prescription and lens design. RESULTS: Thirty-three children were included (66 eyes), mean age was 9.6 years at the start of treatment. Over a follow-up of up to 2 years, AL growth was 0.14 mm/year (95% CI 0.07–0.21, p<0.001) and SER shifted by –0.38 D/year (95% CI –0.52 to –0.24, p<0.001), both below fast-progres- sion thresholds (≥0.30 mm/year and ≥–0.50 D/year). CONCLUSION: In our cohort, specialized spectacle lenses were associated with reduced myopia progression. Collected data regarding lifestyle habits highlighted the need to improve pa- rental literacy related to myopia and associated risk factors, to encourage healthier lifestyle habits and potentially reduce long-term risk.